Psychiatry Flashcards

A 60-year-old woman with recent onset depression, weight loss, psychomotor retardation, and nihilistic delusions (believing her organs are rotting) most likely has which condition?

Answer: Major depressive disorder with psychotic features

Major depressive disorder with psychotic features (psychotic depression) presents with severe depressive symptoms plus mood-congruent psychotic features such as nihilistic delusions (Cotard syndrome), delusions of guilt, or auditory hallucinations. Nihilistic delusions are strongly associated with severe depression in the elderly.

A healthcare worker in Saudi Arabia suspects child abuse. According to Saudi child protection law, what is the appropriate action?

Answer: Report to the child protection authority (mandatory reporting)

Under Saudi child protection law and SCFHS professional standards, healthcare workers are mandated reporters of suspected child abuse. Reporting to the child protection authority is mandatory, regardless of certainty. Failure to report can result in legal consequences.

A 25-year-old man presents with excessive hand washing (>30 times daily) and fear of contamination. He recognises his behaviour is excessive but cannot stop. What type of symptoms are the intrusive thoughts?

Answer: Obsessions

Obsessions are recurrent, intrusive, unwanted thoughts, images, or urges that cause marked anxiety (fear of contamination). Compulsions are repetitive behaviours (hand washing) performed to reduce the anxiety caused by obsessions. Insight is preserved in OCD.

What is the most common psychiatric comorbidity in patients with substance use disorders?

Answer: Depressive disorders

Depressive disorders are the most common psychiatric comorbidity in substance use disorders (dual diagnosis). Depression can be both a risk factor for substance use and a consequence of it. Integrated treatment addressing both conditions simultaneously is recommended.

A 40-year-old woman presents with paralysis of the right arm that occurred suddenly after a family argument. She seems unconcerned about the paralysis. Neurological examination reveals inconsistencies — she can unconsciously use the arm in certain postures. Which test finding supports conversion disorder?

Answer: Positive Hoover sign

Hoover sign is positive when there is involuntary hip extension during contralateral hip flexion against resistance, demonstrating that the 'paralysed' leg has preserved motor function. This is a clinical sign of functional (non-organic) weakness and supports conversion disorder.

Which of the following features distinguishes delirium from dementia?

Answer: Fluctuating consciousness with acute onset

Delirium is characterised by acute onset, fluctuating consciousness, impaired attention, and often a identifiable precipitant (infection, medication). Dementia has a gradual onset, progressive course, and preserved consciousness until late stages. Delirium is potentially reversible.